0FT88ZZ
Resection Cystic Duct to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | F Hepatobiliary System and Pancreas |
| Operation | T Resection |
| Body Part | 8 Cystic Duct |
| Approach | 8 Via Natural or Artificial Opening Endoscopic |
| Device | Z No Device |
| Qualifier | Z No Qualifier |
Operation Definition
Cutting out or off, without replacement, all of a body part
Procedure Overview
Resection covers the complete removal of a hepatobiliary or pancreatic organ or anatomically distinct portion, without replacing it with a graft or device. The most familiar example is cholecystectomy, the complete removal of the gallbladder, typically performed for symptomatic gallstones, chronic inflammation, or gallbladder cancer. Other examples include total pancreatectomy and complete removal of an anatomically whole lobe of the liver when disease affects the entire segment.
These procedures are chosen when disease, such as cancer, severe infection, or irreversible organ damage, involves an entire anatomically distinct body part and leaving any of it behind would not resolve the underlying problem. Because the liver and pancreas perform essential metabolic and digestive functions, surgeons carefully weigh how much can be safely removed before turning to resection of a whole part rather than a partial excision.
Anatomy & Axis Detail
Cystic Duct
The cystic duct connects the gallbladder to the common hepatic duct, joining it to form the common bile duct, and its variable length, angle of insertion, and occasional spiral valves of Heister make it a frequent source of confusion during cholecystectomy and a well-known site of injury or retained stone impaction. Isolated resection of the cystic duct beyond routine cholecystectomy is performed when a stump remnant becomes symptomatic, harbors a retained stone, or shows tumor involvement after prior gallbladder removal, requiring careful dissection to avoid the adjacent common bile duct and right hepatic artery. Because the duct's small caliber and short course leave little room for partial excision, removal is generally complete rather than segmental, and it is coded as Resection when no portion of the duct is left behind.
Approach: Via Natural or Artificial Opening Endoscopic
Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.
Coding & Documentation
For Resection to apply, the documentation must show that an entire anatomically distinct body part, such as the whole gallbladder, an entire hepatic lobe, or the whole pancreas, was removed, not just a margin or lesion. When only a portion of an organ is taken, such as a wedge of liver tissue or the pancreatic tail alone, the case should instead be coded as an excision, a distinction that trips up coders regularly. Pathology and operative reports should be cross-referenced to confirm the full extent of what was removed and whether any organ tissue remained in the patient.